Academic journal article Human Ecology

Iron Plays a Major Role in Nutrition

Academic journal article Human Ecology

Iron Plays a Major Role in Nutrition

Article excerpt

From infant formula to flour, iron-fortified foods are so commonplace on U.S. grocery shelves--and have been since the 1940s--that few Americans realize iron deficiency is one of the most prevalent forms of malnutrition, affecting more than one-fifth of the world population, or 1.4 billion people. Those lives would be changed dramatically by a small quantity of iron, an essential micronutrient.

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An estimated 841,000 people died as a result of iron deficiency in 2000, says Rebecca Stoltzfus, associate professor in the Division of Nutritional Sciences. Five thousand of those deaths occurred in the United States.

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The statistics she cites are from the Global Burden of Disease 2000 project (GBD 2000), a study sponsored by the World Health Organization and the World Bank in which Stoltzfus participated with more than 100 international researchers who had been enlisted to assess world health conditions. GBD 2000 ranked iron deficiency ninth among the risk factors that contribute to human death and disability. In addition to death, iron deficiency collectively costs sufferers approximately 35 million disability-adjusted life years (years spent in less than full health) each year. These statistics have not changed much in two decades.

"There is no excuse for the scientific and public health community to be complacent about iron deficiency," Stoltzfus insists. "Although many experts agree that in poverty-stricken populations iron deficiency is not being adequately controlled, consensus has not been reached about the public health consequences of the deficiency and which populations deserve primary attention in terms of intervention."

Iron deficiency is perhaps best known for its association with anemia. It is, in fact, one of the major causes of the disease, which lowers a person's red blood cell count below normal. Red blood cells carry oxygen to tissues throughout the body. The oxygen is needed for the normal functioning of cells and combines with food to release energy. An anemic person adapts to the decrease in oxygen by becoming less active--hence, the fatigue and weakness that are characteristic of the condition.

In certain parts of the world, primarily in less-developed countries, anemia has a far greater impact. Women of reproductive age and children are most vulnerable to developing iron-deficiency anemia (IDA) because their requirements for iron are high. IDA in pregnant women is associated with perinatal mortality--death of the fetus or newborn baby. Anemia also puts the mother at risk of dying in childbirth, often as a result of postpartum hemorrhaging, which could be prevented if medical services such as transfusions were immediately available. Such help is unlikely in remote parts of the world. Testing of anemic children reveals poor mental and motor performance in infants and toddlers and impaired cognitive function in schoolchildren.

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"Enough evidence exists to indicate that iron deficiency adversely affects brain development in babies," Stoltzfus says. "Part of my research has been to help determine the extent of those developmental deficits and how important they are for the long-term development, education, and well being of the child."

Stoltzfus's research takes her to impoverished communities in rural Nepal and Tanzania, in eastern Africa, where it is common to find 80 percent of the toddlers afflicted with IDA; by comparison, seven percent of North American children are anemic. A number of factors contribute to this disparity.

Stoltzfus explains that low-birth-weight babies are frequently iron deficient, a condition determined in large part by mothers' health. In some Southeast Asian countries, including Nepal, as many as 60 percent of the women have IDA. When an iron-deficient woman is pregnant there is growing evidence that she is unable to pass on to her fetus adequate amounts of iron, which the fetus needs to accumulate to ensure healthy development during its first six months as an infant. …

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